Observational studyEuropean heart journal2017
Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: two prospective cohort studies.
Observational study in European heart journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 368 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
368 citing papers in PubMed, 3 syntheses or guidelines pooled it, 682 citations in OpenAlex.
- The high-density lipoprotein lipidome in metabolic syndrome: A systematic review.European journal of clinical investigation · 2026Pooled it
- Pooled it
- High-density lipoprotein particles are associated with the risk of mortality from all-causes and cardiovascular diseases (CVDs) in patients with CVD: a systematic review and meta-analysis study.Lipids in health and disease · 2025Pooled it
- Obicetrapib in patients with heterozygous familial hypercholesterolemia: the BROOKLYN randomized clinical trial.Nature medicine · 2026Trial
- Effect of Hormone Therapy on Lipoprotein Subfractions in Early and Late Postmenopausal Women.The Journal of clinical endocrinology and metabolism · 2025Trial
- Cardiovascular Effects Associated with the Female Athlete Triad: Emerging Evidence Statement from the Female and Male Athlete Triad Coalition.Sports medicine (Auckland, N.Z.) · 2026Review
- Multiomics Insights Linking Personal Care Products Exposure to Serum Lipid Profiles in Older Adults: The China BAPE Study.Environmental health perspectives · 2026Article
- Maternal Diglyceride Diet Attenuates Selected Metabolic Effects of Maternal High-Fat Feeding in Offspring via Energy Metabolism and Microbiota Modulation.Food science & nutrition · 2026Article
- Metabolic reserve: baseline cholesterol as a predictor and modulator of response to in-hospital exercise in older adults.The journal of nutrition, health & aging · 2026Article
- Development and Validation of Isocratic RP-UHPLC Method for Assay of Fenofibrate Tablet.Biomedical chromatography : BMC · 2026Article
- Reconceptualizing Dyslipidemia: Diversity of Lipid Imbalances and Their Clinical Implications; A Narrative Review.Health science reports · 2026Article
- Machine-Learning-Based Evaluation of the Prognostic Significance of the Non-High-Density Lipoprotein to High-Density Lipoprotein Cholesterol Ratio in Critical Ischemic Stroke.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- The association of childhood HDL cholesterol with atherosclerotic cardiovascular disease events in adults: findings from the International Childhood Cardiovascular Cohort Consortium.European journal of preventive cardiology · 2026Article
- Unmet Cardiovascular Risk Beyond LDL-C: A Perspective on Managing Residual Cardiovascular Risk.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Association Between HDL Cholesterol Changes and Cardiovascular Event Risk: A Nationwide Health Screening Cohort in Japan.Healthcare (Basel, Switzerland) · 2026Article
- Evaluation of High-Density Lipoprotein Capacity to Acquire Free Cholesterol From Triglyceride-Rich Lipoproteins During Reverse Remnant-Cholesterol Transport in Familial Hypercholesterolemia.Endocrinology, diabetes & metabolism · 2026Article
- High-Density Lipoprotein Treatment Effectively Protected the Endothelial Cells, Mitochondria and Myocardium Against Oxidized Low-Density Lipoprotein Damage.Acta Cardiologica Sinica · 2026Article
- The Role of Obesity in the Association Between Alcohol Consumption and HDL-c Levels: Baependi Heart Study.Lipids · 2026Article
- Article
- The association of nontraditional lipid parameters with all-cause and cardiovascular mortality: A national cohort study.Medicine · 2026Article
308 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsHigh-density lipoprotein (HDL) cholesterol concentrations are inversely associated with cardiovascular disease and mortality across a range of concentrations, but genetic evidence suggest that extreme high concentrations may paradoxically lead to more cardiovascular disease. We tested the hypothesis that extreme high concentrations of HDL cholesterol are associated with high all-cause mortality in men and women. METHODS AND
resultsA total of 52 268 men and 64 240 women were included from the two prospective population-based studies, the Copenhagen City Heart Study and the Copenhagen General Population Study. During 745 452 person-years of follow-up, number of deaths from any cause were 5619 (mortality rate, 17.1/1000 person-years (95% confidence interval (CI): 16.7-17.6)) in men and 5059 (mortality rate, 12.1/1000 person-years (11.8-12.4)) in women. The association between HDL cholesterol concentrations and all-cause mortality was U-shaped for both men and women, with both extreme high and low concentrations being associated with high all-cause mortality risk. The concentration of HDL cholesterol associated with the lowest all-cause mortality was 1.9 mmol/L (95% CI: 1.4-2.0) (73 mg/dL (54-77)) in men and 2.4 mmol/L (1.8-2.5) (93 mg/dL (69-97)) in women. When compared with the groups with the lowest risk, the multifactorially adjusted hazard ratios for all-cause mortality were 1.36 (95% CI: 1.09-1.70) for men with HDL cholesterol of 2.5-2.99 mmol/L (97-115 mg/dL) and 2.06 (1.44-2.95) for men with HDL cholesterol ≥3.0 mmol/L (116 mg/dL). For women, corresponding hazard ratios were 1.10 (0.83-1.46) for HDL cholesterol of 3.0-3.49 mmol/L (116-134 mg/dL) and 1.68 (1.09-2.58) for HDL cholesterol ≥3.5 mmol/L (135 mg/dL).
conclusionMen and women in the general population with extreme high HDL cholesterol paradoxically have high all-cause mortality. These findings need confirmation in other studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.